Perrella, A.; De Sio, I.; Bellopede, P.; Maddaloni, A.; Vitale, L.M.; Adinolfi, L.E.; Rinaldi, B.; Izzi, A.; Sbreglia, C.; Bernardi, F.F.; Trama, U.; Rinaldi, L. Late HCC Occurrence in Patients Achieving SVR after DAAs Therapy: A Matter of Follow-Up or Something Else?. Preprints2023, 2023090048. https://doi.org/10.20944/preprints202309.0048.v1
APA Style
Perrella, A., De Sio, I., Bellopede, P., Maddaloni, A., Vitale, L.M., Adinolfi, L.E., Rinaldi, B., Izzi, A., Sbreglia, C., Bernardi, F.F., Trama, U., & Rinaldi, L. (2023). Late HCC Occurrence in Patients Achieving SVR after DAAs Therapy: A Matter of Follow-Up or Something Else?. Preprints. https://doi.org/10.20944/preprints202309.0048.v1
Chicago/Turabian Style
Perrella, A., Ugo Trama and Luca Rinaldi. 2023 "Late HCC Occurrence in Patients Achieving SVR after DAAs Therapy: A Matter of Follow-Up or Something Else?" Preprints. https://doi.org/10.20944/preprints202309.0048.v1
Abstract
The rapid introduction of DAAs has revolutionized the treatment of chronic HCV infection, however some concerns have been arose about their early and long term safety in real life settings. Therefore, these drugs achieve a robust and sustained virological response in a short duration of treatment, being a quick winning option, but, what then? At now an extensive follow-up in real life settings does not exist particularly on HCC occurrence as recently suggested in a Cochrane review . In this regard from February 2015 to December 2017 a group of 5 Hospital and Academic Centers in Southern Italy (Campania Region) managed an observational, prospective, real-life study on efficacy and safety of DAAs treatment schedule enrolling 1022 consecutive HCV patients treated with IFN-free DAAs regimens being followed-up for 24 months. Our preliminary data on the first 360 patients out of 1022 whose completed at least 66 weeks follow-up, based on clinical, laboratory and expert ultrasonography every three months, showed an SVR in 342 out 360 (95%) patients of which 9 had a new diagnosed HCC (2.63%). Specifically HCC developed in mean after 16,2 months after end of treatment as one or more nodules (2-3 cm in mean) with an increase in alpha-fetoprotein 10 x u.n.v (n.v. <15 UI/mL) in patients with F4 fibrosis staging at the time of treatment enrolment. In conclusion, in view of our findings and literature evidences, regular clinical, laboratory and expert ultrasonography follow-up should carefully performed also on these patients and the current Faster, Higher, Stronger approach to the new antivirals development should strongly be revisited in the light of possible late adverse events like HCC occurrence and the relative economic impact on health care system cost.
Medicine and Pharmacology, Oncology and Oncogenics
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